- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.00 / $1,869.00 / $4,050.00
| Facility | | $762.00 | $1,869.00 | $4,050.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,036.00 / $3,000.04 / $15,931.60
| Facility | 50 | $1,036.00 | $3,000.04 | $15,931.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,551.66 / $10,010.81 / $18,385.55
| Facility | | $5,551.66 | $10,010.81 | $18,385.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,843.21 / $7,843.21 / $7,843.21
| Facility | | $7,843.21 | $7,843.21 | $7,843.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $5,780.00 / $12,353.00
| Facility | | $1,200.00 | $5,780.00 | $12,353.00 |